Background: Dysmenorrhea affects most reproductive-aged women . Common dysmenorrhea treatments vary in their effectiveness across individuals . Little is known about factors associated with perceived treatment ineffectiveness . The objectives of this study were to describe the perceived ineffectiveness of common pharmacological treatments for dysmenorrhea and investigate factors associated with perceived treatment ineffectiveness . Materials and
Methods: In this cross-sectional study, 678 women with dysmenorrhea (aged 14-42) provided data on perceived treatment ineffectiveness, dysmenorrhea symptom-based phenotypes, demographics, clinical factors, and psychobehavioral characteristics . We used Fisher's exact tests to compare treatment ineffectiveness across three symptom-based phenotypes . We used logistic regressions to explore associations of phenotype, demographic, clinical, and psychobehavioral correlates of perceived treatment ineffectiveness .
Results: Percentages perceiving treatments as ineffective were 29.3% -35.6% nonsteroidal anti-inflammatory drugs , 49.9% acetaminophen, and 39.3% combined oral contraceptive pills (OCPs). Factors associated with perceived ineffectiveness varied across treatments and included symptom-based phenotypes, clinical, and psychobehavioral factors . For ibuprofen and acetaminophen, women with severe (vs. mild) pain phenotype and higher number of chronic pain conditions were more likely to perceive the treatments as ineffective . For OCPs, women with severe pain (vs. mild) phenotype, comorbid gynecological condition, less anxiety, and worse depressive symptoms were more likely to perceive the treatment as ineffective . Conclusion: A significant percentage of women reported ineffectiveness of dysmenorrhea treatments . Phenotypes, clinical, and psychobehavioral factors were associated with treatment ineffectiveness . Future research should test if symptom-based phenotypes are associated with treatment effectiveness in clinical trials and investigate other factors that affect dysmenorrhea treatment effectiveness, so treatments can be tailored to individuals.
Index: chronic pain, dysmenorrhea, pain, pelvic pain, treatment outcome